OB care plan using maslow

[DChristine]

i am trying to list my nursing dx in order using maslow's. my pt is a nonenglish speaking postpartal cesarean. she is breastfeeding and husband translates. fundus firm at umbilicus. her blood pressure was low and given iv bolus to bring up.

rbc 3.86 low

hgb 11.6 low

hct 34.5 low

problem list

1. fluid volume deficient r/t blood and electrolyte loss associated with surgery, postpartum hemorrhage.

2. risk for infection r/t delivery and secondary to surgical incision, decreased hb, indwelling catheter, anesthetic administration, breastfeeding, spinal analgesia injection, and i.v. lines

3. impaired tissueintegrityr/t surgical incision and itching from spinal analgesia

4. acute pain r/t surgical incision and trauma

5. imbalanced nutrition: less than body requirements r/t lack of intake prior to surgery and patient's unfavored post surgery clear liquid diet

and by physiologic response to abdominal surgery

6. impaired urinary elimination r/t results of l&d

7. knowledge deficit r/t lack of english, misinterpretation

8. breast feeding ineffective r/t mothers dissatisfaction in providing total nutrition from breastfeeding and supplementing with formula

9. sleep deprivation r/t breast feeding and care of infant needs

10. risk for constipation r/t decreased muscle tone, analgesia, lack of intake, breastfeeding

do i have these problems in the right order????

[Daytonite, BSN, RN]

Do I have these problems in the right order?

No.

1. Fluid Volume Deficit r/t blood and electrolyte loss associated with surgery and postpartum hemorrhage. [physiological need for fluid]
   
2. Ineffective Breast Feeding r/t mothers dissatisfaction in providing total nutrition from breastfeeding and supplementing with formula [physiological need for nutrition]
   
   • too many words
     
   • Just say Ineffective Breast Feeding r/t infant needing to receive supplemental formula feedings
     

[*]Imbalanced Nutrition: less than body requirements r/t lack of intake prior to surgery and patient's unfavored post surgery clear liquid diet and by physiologic response to abdominal surgery [physiological need for nutrition]

• The patient's symptoms are simply because she hasn't had enough intake
  
• Imbalanced Nutrition: less than body requirements r/t lack of intake
  

[*]Impaired urinary elimination r/t results of L&D [physiological need for elimination]

• What are "results of L&D"? What is the impaired urinary problem in the first place caused by the "results of L&D"? Your instructor is going to ding you for this
  

[*]Sleep Deprivation r/t breast feeding and care of infant needs [physiological need for rest]

[*]Acute Pain r/t surgical incision and trauma [physiological need for comfort]

[*]Impaired Tissue Integrity r/t surgical incision and itching from spinal analgesia [safety need]

[*]Impaired Verbal Communication R/T language barrier AEB [nonenglish speaking - husband translates] [safety/security need]

[*]Knowledge deficit r/t lack of English, misinterpretation [self-actualization need]

• you must state a subject of the deficient knowledge; incorrect related factor for this diagnosis; use Impaired Verbal Communication instead
  

[*]Risk for constipation r/t decreased muscle tone, analgesia, lack of intake, breastfeeding [anticipated physiological need for elimination]

• Is breastfeeding a cause of constipation?
  

[*]Risk for infection r/t delivery and secondary to surgical incision, decreased Hb, indwelling catheter, anesthetic administration, breastfeeding, spinal analgesia injection, and I.V. lines [anticipated physiological need for physical body regulation]

• Just say Risk for Infection R/T surgical intervention, invasive procedures and inadequate secondary defenses
  

[Bortaz, MSN, RN]

I'm starting OB next Monday. Not sure I'm looking forward to it.

[DChristine]

I love OB. We are doing peds now and I find it hard. Communicating with sick children is not easy. My patient was two, so he was not really fearful of me, but the 4 year old in the other room would not say a word to me.